Silent but not Deadly

Silent but deadly is a phrase most often used to describe the effects of a quiet crepitation that is extremely potent in its olfactory impact. It could as well refer to the phobias of many concerning the deadly forces of modern life. These are the forces of modern life that allegedly pervade our environment and threaten our very existence. Vying for the top of the list are those all-pervasive chemical carcinogens that allegedly saturate our food and every other aspect of our environment. Competing
for phobic primacy is all that deadly radiation emanating from nuclear power plants. When old phobias begin to lose some of their power to frighten, there are people skilled at heightening our sensitivities to newly emerging dangers such as transgenic or genetically modified food or food irradiation. Like the old soldiers who never die, some old phobias seem to linger on: the dangers of immunization or the connection between electric power lines and cancer (a fore runner to the mobile phone-brain cancer phobia), or even the harm from pasteurization. Unlike the old soldiers, however, old phobias never quite seem to fade away.

Being unseen and silent makes the threats of modern life ever more frightening. Our unawareness of these dangers means that we need sentinels who shoulder the
responsibility for constantly alerting us to them while seeking our contribution to their organizations. Little evidence is ever required for the validity of this danger, and as belief builds upon belief, each new danger seems to validate beliefs about the older ones, with an emerging consensus among the nervous that modern life is dangerous. Dangers that one can see or hear can eventually be verified or falsified – and so can the unseen dangers, but this is a matter of scientific evidence, a notion which is not universally accepted.

Modern life has protected us from so many of the dangers that were once a frequent scourge to the very young and the old and many between, that the very safety of modern life has relieved us of the fear of them. This seems to have opened a niche to be filled in with new fears. The very success of modern life in allowing us to live longer, healthier lives should, in aggregate at least, stand as a massive refutation of those whose livelihood is fear -mongering. Like the “curious incident” of the dog that didn’t bark in Conan Doyle’s Silver Blaze, the story of our time might be told in terms of cancer epidemics or other disasters that many people believe happened but didn’t.

I often ask my students to guess how many of them would be here if the birth and death rates of 1900 had prevailed throughout the century. Based on the study of Kevin M. White and Samuel H. Preston (1996), if 1900 birth and death rates had prevailed throughout the century, half of them would not be here. This half extends across all age groups. For the older among us, we might well have been born but would have likely already died. For my students, half of them would also not be here, having
died at birth or in childhood, or never having been born because a parent or grandparent did not live long enough to have children. It is easy to cite the various infirmities that took their toll before the arrival of modern public health and/or
pharmaceuticals. For citizens from the developing world, without the changes in mortality in just the last half century, one quarter of them would not be alive had 1950 death rates prevailed (Heuveline 1999). Statistically, this is even a more extraordinary feat than the one-half for the century. How many of them realize that they or a pre-reproductive parent would have been the Grim Reaper’s prize, without the last
century’s scientific and technological changes that have transformed modern life? A few might have been the beneficiaries of some heroic life-saving procedure, but the vast majority of those of us now alive simply do not know whether or not we would be among the living or the dead without the life-saving capabilities of modern life.

Most of us are the beneficiaries of the
silent but life-saving forces that have emerged
over the last century. Factors such as clean
water and immunization are taken for granted –
except when scares arise about their alleged
dangers. Our children can be immunized with up to
eleven injections at an age that they can no
longer remember when they become adults. Even I
as a beneficiary of the 20th century have to
marvel at the fact that these eleven
immunizations contain fewer antigens than the one
smallpox vaccination that I had as a boy. Yet the
fears about immunization grow louder and more
strident as the immunizations become ever safer.

We benefit from the advances of our time,
memories of which often lie in the hidden
recesses of our minds – until we are called upon as
parents to have our own children protected by
immunization or cured with an anti-biotic.
Equal in importance to the benefits of what is
there, are the benefits from what is no longer in
our operating environment or which is at least
reduced to levels more manageable by our immune
system. It is the unseen micro-organisms that are
no longer in our food or water (at least
not in the concentrations that can be life
threatening) that allow us to safely partake of
the food and drink that quite literally sustain
our life; or it is the carcinogenic smoke that no
longer fills the indoor atmosphere of our homes
as a result of not cooking and heating with open wood
fires. In other words, our lives are sustained by
all the things that are unseen because they are
no longer there, or those life-saving items like
immunization and antibiotics that are not always
visible. For antibiotics or immunization, it is
not only the protection that we receive when we
contact the disease but also the protection we
receive from not getting ill because others are also protected.

A recent article and editorial in theAmerican Journal of Clinical Nutrition
illustrated a silent but life-saving factor
of modern life (Pfeiffer et al. 2005 and
Rosenberg 2005). It concerned the results of the
1998 mandating of folic acid fortification.
“Mandatory folic acid fortification of cereal
grain products was introduced in the United
States in 1998 to decrease the risk that women
will have children with neural tube defects”
(Pfeiffer et al. 2005). The study demonstrated
that “every segment of the US population appears
to benefit from folic acid fortification”
(Pfeiffer et al. 2005). The earlier scientific
study “of folic acid fortification as an approach
to prevent neural tube defects is a latter day
example of the application of meticulously
controlled scientific trials to insightful
previous hypotheses and observational studies.
These controlled trials led the FDA to mandate
folic acid fortification of the diet” (Rosenberg 2005).

The decision for the folate mandate was
taken in a very open democratic way with
opportunity for informed support or criticism. It
would not have been difficult for some activist
group to campaign against it on the ground that
we were surreptitiously experimenting with
pregnant mothers, infants and children without
fully understanding the unknown dangers lurking
menacingly in the background. With the folate
mandate, there was no thought of consumer choice.
No doubt groups skilled in public advocacy would
have found it easier to frighten people than
scientists would have found it to inform them.
Fortunately, no major group opposed it. Few
outside those professionally interested (and
informed) knew about it. One can guess – and it is only a
guess on my part – that those most in need of the
folate supplementation are likely to be the poor
and least educated, who would also most likely
(another guess) be least aware of the mandate or
that folate had been added to their bread.

Vitamins were first identified in 1914, and
the first vitamins were commercially available in
the 1920s. “The synthesis of folic acid by
Lederle Labs in 1947 was one of the milestones
achieved during the era of discovery of vitamins
in the first half of the 20th century. This
stable and unreduced form of folate has served
wonderfully in preventing and treating folate
deficiency and for much of the study of folate
biology” (Rosenberg 2005). It should be noted, for
those who are willing to pay a premium for a
vitamin if it is labeled “all natural” that “folic
acid is not the natural form of the vitamin as it
exists in food” (Rosenberg 2005). In a sense,
most vitamins in pill form are unnatural
(to the extent that that means anything), as we get most of our
vitamin intake as part of complex proteins.
“Although folic acid is not the natural food form
of this vitamin (6), folic acid fortification has
resulted in a profound improvement in nutritional
status and has had a substantial effect on the
original target – neural tube defects” (Rosenberg
2005). It should also be noted that excessive
intake can be harmful, which should be of
interest to those who pop mega-doses of
vitamins and other substances in the belief that
they are somehow following Nature’s path to a longer life.

The efficacy of “folic acid supplementation during the
periconceptional period for the prevention of
spina bifida and related neural tube defects” has
been demonstrated, as has “food fortification as
the most feasible approach to increasing folic
acid intakes in women before conception”
(Rosenberg 2005). There are other
studies which find that increased folate intake
during the periconceptional period leads to a
reduction in childhood leukemia, and others again
which indicate that increased folate intake may
help in delaying the onset of Parkinson’s
disease. How many of the beneficiaries of this
intervention even know that they are beneficiaries, and how many
of the rest of us even know that a “silent”
life-saving product has been added to our
bread? How many parents of a healthy baby know
that the nutritional status of the mother would
have resulted in a newborn with spina bifida
and related neural tube defects if it had not
been for the mandated folate fortification?

Following the publication of the study
showing the benefits of the 1998 folate
enrichment mandate, another peer-reviewed report
was announced, which argued that even more lives would
be saved from deadly disease with a larger dose of
folate in flour. Even our most beneficial
interventions can be subject to further debate,
though in this case, the dispute concerns the
possibility of even greater benefit, not whether
there is benefit. This does reflect the difference
between science and non-science. No human action
of any kind is ever totally free of
risks. In some instances perceived risks are very
real, but dwarfed by the magnitude of the
benefits. The realized risks become a new
problem to solve by means other than foregoing
the massive benefit. In the case of folate, there
is the risk that folate intake can mask a severe
vitamin B-12 deficiency until irreparable nerve
damage results from it. In cognizance of that,
vitamin B-12 deficiency was examined in the study
and others are arguing for vitamin B-12 enrichment along with the folate.

Even with a great success story, some
scientists will undoubtedly find ways that it
might be made even better. Other scientists who
accept the benefits of folate enrichment might
disagree that more is needed, or even that more
would be beneficial. In modern interventions in
science and technology, there is always room for
improvement and even more room for disagreement.
What is too often not recognized is that those in
the most heated disagreement may in fact be in
agreement (along with others in their profession)
about basic principles, and be arguing about their
interpretation or about peripheral issues which
may have important applied implications.

Unfortunately the professional anti-science
practitioners will seize on these disagreements,
magnify them, and use them to argue against
established scientific theories and often against
scientific inquiry itself. Given that PhD
scientists number into the hundreds of thousands,
activists will have no difficulty rounding up a
few who support their anti-science agenda.
Science is a form of open inquiry in which every
belief can be subject to challenge by those who
might have a better theory, and evidence in
support of it, that is better than what is
currently believed. This is one of the ways in
which progress is maintained. But some theories
are so solidly established in terms of the
supporting evidence and the effective use to
which they are being put, that criticism of them
carries a significant burden of necessary
evidence. By creating a public belief that there
is a “controversy” in an area of scientific
inquiry and that scientists are “divided” on the
issue, activists use “mythic” controversy to
further an agenda such as opposition to
beneficial endeavors such as genetically modified
(technically, transgenic) agriculture and food
production, immunization of various kinds, and the
teaching of evolution. Let’s face it, though they
may be poles apart politically and hold each
other in utmost contempt, there are striking
similarities between those who oppose modern
biotechnology or modern science and technology in
general, and those whose advocacy of
creationism/intelligent design pits them against
modern biology. Some of us might argue that
though the superficial rhetoric may be different,
the underlying belief systems of the two groups are virtually identical.

By vociferously and convincingly denying
the benefits of a practice, critics claim no
obligation to offer an alternative except to
abandon the practice. Or they endless repeat
clichés such as “we have enough food in the world
to feed everyone” without having to answer how
could we have gotten enough food in the world to
feed everyone without the Green Revolution
technologies that they also opposed,
and how will we feed another possibly 3 billion
people by 2050 without new yield improving technologies?

Given the extraordinary gains that we have
made over the last century in life expectancy, it
would seem obvious that we must be doing
something right. In the
20th century, in the United States we added
nearly 30 years of life expectancy and reduced
infant mortality by over 90%. Other advanced
countries did even better, in some cases much
better that we did. In developing countries,
about 20 years of life expectancy have been added
in the last 50 years. Changes of these magnitudes do not happen for no reason at all. To
repeat, we must be doing something right. We
therefore have a right to ask critics if they are opposing the very processes that
brought us these gains? If there is a problem
such as an adverse reaction to an immunization
that is otherwise beneficial, are they advocating
that we seek a solution to the problem or that we
simply forego the process entirely, benefit and
all? Do they have an alternative that produces
more benefit with less risk, and what is their
evidence for it? In other words, we have as much
right to demand answers from the critics as the
critics have to demand answers from the rest of
us. Too many critics seem to be operating under
the assumption that we were better off in some prior time.

No matter how far we advance, there will
always be errors and potential harm, and there will always be a vital need to
have those who seek out problems and to
publicize and seek to remedy them. It is critics of
this kind that have been an essential element in
getting us where we are today. There is much
more than a semantic difference between those
whose criticism springs from a basic acceptance
of the gains that we have made, and the
criticism that seeks to recapture that which we
have lost or that finds ideological solace and
vindication in every failure in science,
technology and modern life. The latter will
opportunistically seek fault where ever they can
find it, whether it be real or imaginary. To some
of us, their seeming joy in every failure is mean
spirited and anti-human. For critics to escape
this Luddite trap, their critique of any aspect
of modern life has to be cognizant of the silent
but powerful forces moving in the background that
have so dramatically transformed our lives for the better.

Dr. Thomas R. DeGregori is a Professor of
Economics, University of Houston. He is widely
published – his most recent books include:
Origins of the Organic Agriculture Debate; The
Environment, Our Natural Resources, and Modern
Technology and Agriculture and Modern Technology:
A Defense (Blackwell Publisher for all three) and
Bountiful Harvest: Technology, Food Safety, And
The Environment (Cato Institute). Author’s
homepage is http:www.uh.edu/~trdegreg and email address is trdegreg@uh.edu.